The purposes of this study were to examine the prevalence rates for different levels of posttraumatic stress disorder (PTSD) and the severity of psychological symptoms following the commission of violent crime and to explore the interrelationship between PTSD from past trauma, alexithymia, PTSD following a violent crime, and psychological symptoms. The study participants, 339 male perpetrators of violent crime, completed the Posttraumatic Stress Diagnostic Scale, the General Health Questionnaire–28, and the Toronto Alexithymia Scale–20. Results showed that 37%, 14%, and 49% met criteria for full, partial, and no PTSD, respectively. The full-PTSD group reported significantly more anxiety, social dysfunction, and depression than did the no-PTSD group. PTSD from past trauma was the strongest predictor for PTSD following violent crime. PTSD from past trauma and difficulty identifying feelings predicted psychological symptom severity. PTSD from past trauma mediated the paths between difficulty identifying feelings and PTSD following violent crime or psychological symptom severity. The study showed that perpetrators can develop full and partial PTSD and other psychological difficulties following violent crime. The effect from past traumas and perpetrators’ difficulty in getting in touch with their feelings can affect current psychological distress.